Hypertrophic Cardiomyopathy: A New Era in Targeted Therapy

Hypertrophic Cardiomyopathy (HCM) is the most commonly inherited cardiomyopathy worldwide, characterized by left ventricular hypertrophy and hypercontractility. Many cases of HCM are due to pathogenic changes in cardiac sarcomere proteins. Traditional therapies including B-blockers, non-dihydropyridine calcium channel blockers and septal reduction therapy have long provided symptomatic relief, but they have not necessarily addressed the disease state at the cellular level. The treatment landscape for HCM has evolved significantly over the last decade with the emergence of new targeted therapies, including a new class of medication called cardiac myosin inhibitors (CMI). CMI therapy represents a paradigm shift in the management of obstructive variants of HCM, offering meaningful improvement in symptoms and cardiac function parameters. CMI therapy remains investigational in the treatment of non-obstructive variants of HCM. This review examines the evolving understanding of HCM and highlights both traditional management strategies and emerging therapies.